Email Address *

First Name *

Last Name *

What is the gender you self-identify with? *

What ethnicity/ethnicities do you self-identify with? *

Full mailing address *

Best contact number in case we need to reach you: *

Are you currently a high school or college/university student? *

If yes, what is the name of your institution? (mark N/A if you answered No). *

Highest Degree Achieved as of today: *

Are you currently employed? *

If yes, what is the name of your current employer/organization? (mark N/A if you are not currently employed) *

What is your current position in your organization? *

What is your industry? *

If other industry, please specify. Otherwise mark N/A. *

How did you learn about NAAAP Detroit? *

What is your Facebook profile URL? (If you don’t have one please mark N/A) *

What membership benefit is most important to you? *

If other, please specify. Otherwise mark N/A. *

Would you like to volunteer to help us plan, implement or grow? *

If Yes, please indicate which committees interest you the most (you may pick more than one): *

Membership Type (if you are a student, or, if you are registering as an employee of one of our sponsors, please select “Will have to complete membership manually” and contact membership@naaapdetroit.org to complete your enrollment) *